Provider Demographics
NPI:1700061587
Name:PAT MEDICAL SUPPLY INC.
Entity Type:Organization
Organization Name:PAT MEDICAL SUPPLY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:OLANIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:OLUWOLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-404-4962
Mailing Address - Street 1:1010 S EDMONDS LN
Mailing Address - Street 2:SUITE 105
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-4418
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1010 S EDMONDS LN
Practice Address - Street 2:SUITE 105
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-4418
Practice Address - Country:US
Practice Address - Phone:214-404-4962
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-29
Last Update Date:2007-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies